Prevalence and Psychosexual Determinants of Sexual Functioning and Sex Addiction among Middle-Aged and Older Sexual Minority Men

ABSTRACT Introduction This study aimed to assess the prevalence of sexual problems and sex addiction among a sample of middle-aged and older sexual minority men (MAOSMM) and to determine sexual functioning and sexual addiction predictors among this sample. Methods This study recruited 253 MAOSMM living in Portugal, who ranged in age from 40 to 75 years old (Mage = 58.34, SD = 11.02). 74.9% of participants self-identified as gay, and 25.1% self-identified as bisexual. The study recruited participants via websites, e-mail, and social media. The survey included four categories of questions/measurements, encompassing sociodemographic information, the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Bergen-Yale Sex Addiction Scale, and a sexual behavior questionnaire created for the purposes of this study. Results 10.4% of participants reported sexual problems, while 20.5% presented indicators of sex addiction. Self-identified bisexual men displayed higher sexual functioning, but the study found no significant differences between gay and bisexual men regarding sex addiction. Sexual functioning and sex addiction were strongly correlated (r = .303; p < .001). Moreover, multiple regression analyses showed that psychosexual variables explained 26% of sexual functioning and 17% of sex addiction. Regarding sexual functioning, strong predictors included being younger, being bisexual, possessing lower levels of educational attainment, an absence of mental health problems, frequently engaging in sexual activity, and displaying a high degree of sexual identity acceptance. Regarding sex addiction, strong predictors encompassed having physical problems, a high frequency of sexual activity, and engaging in protected receptive anal sex. Conclusion This study contributes to the adoption of positive measures to promote fundamental sexual rights regarding aging and sexuality among middle-aged and older sexual minority men.